Telephone veteran peer coaching for mental health treatment engagement among rural veterans: The importance of secondary outcomes and qualitative data in a randomized controlled trial
Autor: | Seal, Karen H, Pyne, Jeffrey M, Manuel, Jennifer K, Li, Yongmei, Koenig, Christopher J, Zamora, Kara A, Abraham, Traci H, Mesidor, Marie M, Hill, Coleen, Uddo, Madeline, Hamilton, Michelle, Borsari, Brian, Bertenthal, Daniel, Casey, James J, Kelly, P Adam |
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Rok vydání: | 2021 |
Předmět: |
education
Clinical Trials and Supportive Activities Rural Health Nursing motivational interviewing 7.1 Individual care needs Clinical Research Behavioral and Social Science rural veterans Humans peer interventions health care economics and organizations Veterans Prevention Mentoring Health Services humanities health services research Telephone Brain Disorders Good Health and Well Being Mental Health Quality of Life Public Health and Health Services Management of diseases and conditions Public Health |
Zdroj: | The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, vol 37, iss 4 |
Popis: | PurposeTo determine the effectiveness of telephone motivational coaching delivered by veteran peers to improve mental health (MH) treatment engagement among veterans.MethodsVeterans receiving primary care from primarily rural VA community-based outpatient clinics were enrolled. Veterans not engaged in MH treatment screening positive for ≥1 MH problem(s) were randomized to receive veteran peer-delivered feedback on MH screen results and referrals plus 4 sessions of telephone motivational coaching (intervention) versus veteran peer-delivered MH results and referrals without motivational coaching (control). Blinded telephone assessments were conducted at baseline, 8, 16, and 32 weeks. Cox proportional hazard models compared MH clinician-directed treatment initiation between groups; descriptive analyses compared MH treatment retention, changes in MH symptoms, quality of life, and self-care.FindingsAmong 272 veterans screening positive for ≥1 MH problem(s), 45% who received veteran peer telephone motivational coaching versus 46% of control participants initiated MH treatment (primary outcome) (hazard ratio: 1.09, 95% CI: 0.76-1.57), representing no between-group differences. In contrast, veterans receiving veteran peer motivational coaching achieved significantly greater improvements in depression, posttraumatic stress disorder and cannabis use scores, quality of life domains, and adoption of some self-care strategies than controls (secondary outcomes). Qualitative data revealed that veterans who received veteran peer motivational coaching may no longer have perceived a need for MH treatment.ConclusionsAmong veterans with MH problems using predominantly rural VA community clinics, telephone peer motivational coaching did not enhance MH treatment engagement, but instead had positive effects on MH symptoms, quality of life indicators, and use of self-care strategies. |
Databáze: | OpenAIRE |
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